Background
Methods
Study area and population
Sample size and study design
Data collection method | Participant profile | N | N | N |
---|---|---|---|---|
Kaliro | Serere | Total (combined) | ||
Household visit IDI | Male net user | 5 | 5 | 10 |
Household visit IDI | Female net user | 5 | 5 | 10 |
Household visit IDI | Female net user w/child under 5 | 5 | 5 | 10 |
Photo exercises | All participants | 15 | 15 | 30 |
Photographs | All participants | 15 | 15 | 30 |
Video | All participants | 15 | 15 | 30 |
Observations | All participants | 15 | 15 | 30 |
Data handling and analysis
Ethical considerations
Results
Demographic characteristics
Characteristics | Kaliro N (%) | Serere N (%) | Total (combined) N (%) |
---|---|---|---|
Sex
| |||
Male | 5 (17) | 5 (17) | 10 (34) |
Female | 10 (33) | 10 (33) | 20 (67) |
Age
| |||
≤19 | 0 (0) | 0 (0) | 0 (0) |
20-29 | 6 (20) | 1 (3) | 7 (23) |
30-39 | 3 (10) | 5 (17) | 8 (27) |
40-49 | 1 (3) | 4 (13) | 5 (17) |
50+ | 4 (13) | 5 (17) | 9 (30) |
Don’t know | 1 (3) | 0 (0) | 1 (0) |
Mean age totals | 40 | 45 | 42.5 |
Household Composition
| |||
Mean number of children under 5 | 1.6 | 1.6 | 1.6 |
Mean household size | 7.6 | 6.8 | 7.2 |
Household Characteristics
| |||
Roofing
| |||
Grass/papyrus/banana/thatch | 5 (33) | 4 (27) | 9 (30) |
Zinc/iron/tile | 10 (67) | 11 (73) | 21 (70) |
Walls
| |||
Grass/mud | 5 (33) | 4 (27) | 9 (30) |
Plaster/brick | 10 (67) | 11 (73) | 21 (70) |
Floor
| |||
Earth/sand/clay | 4 (47) | 9 (60) | 13 (43) |
Wood/bamboo/palm | 3 (10) | 0 (0) | 3 (10) |
Vinyl/tile/cement | 8 (53) | 6 (40) | 14 (47) |
Income
| |||
Subsistence agriculture | 7 (23) | 6 (20) | 13 (43) |
Commercial agriculture | 2 (7) | 1 (3) | 3 (10) |
Business owner | 6 (20) | 4 (13) | 10 (33) |
Other | 0 (0) | 4 (13) | 4 (13) |
Education
| |||
Primary | 9 (30) | 6 (20) | 15 (50) |
Secondary | 2 (7) | 2 (7) | 4 (13) |
Higher | 2 (7) | 4 (13) | 6 (20) |
None | 2 (7) | 3 (10) | 5 (17) |
Net Ownership
| |||
Mean number of nets in household | 2.1 | 3.3 | 2.7 |
Causes of damage
Attitudes about torn or unclean nets
Usability
Social norms
Care/maintenance
Repair
Household roles
Reported versus observed behaviour
Discussion
Implications for programmes
Behaviour | Motivators/facilitators | Barriers |
---|---|---|
Repairing a net | • Perceived risk of malaria due to holes | • Holes are too big or too many |
• Belief that mosquitoes can enter even a small hole | • Prefer to replace with new net if affordable | |
• To save money on new nets or malaria treatment | • Duration (how long the repair would take; sewing or patching seen as slow) | |
• Desire to be perceived as responsible and conscientious | • Potential unattractiveness of repair (distortion due to knotting, neatness of sewing, color of material and thread used) | |
• Having a net that looks good (strong dislike of nets with holes) | • Not mentioned: Lack of materials, inability to sew, lack of knowledge of how to repair | |
• Perception that repair can be fast and easy; especially knotting and tying off holes | ||
• Awareness that small holes can get bigger | ||
• Not having enough money to obtain a new net | ||
• Realizing that a net that would have been considered unusable can still be used if repaired | ||
• Needle, threat, and patching materials easily available at low to no cost | ||
• How long the repair would last (sewing and patching seen as longer-lasting, knotting as quick to unravel) | ||
• Men appear to approve of their wives caring for and repairing nets | ||
Washing a net | Motivators for NOT washing frequently: | Barriers to NOT washing frequently: |
• Frequent washing could cause holes | • Desire to be perceived as a clean and responsible person | |
• Older nets more likely to tear during washing | • Frequent washing/cleanliness perceived as good care | |
• Cost of soap (a few participants) | • Believing nets should be treated like clothes and washed following the laundry schedule | |
• Understanding that frequent washing can reduce effectiveness of the ‘medicine’ in the net | • Belief that dirty nets could cause disease | |
• Household factors like bedwetting and dirt floors | ||
• Confusion about proper washing instructions | ||
• Lack of proper washing instruction at distribution | ||
Tying up a net or storing it when not in use | • Recognized as a good ‘routine’ | • Tiring to do daily |
• Prevent damage to nets by children | • Easy to forget | |
• Neat appearance | • Busy with morning rush to work/fields | |
• Heads of households (men and women both) appear to approve in principle |
Care behaviour | Recommendations |
---|---|
Tying up a net or storing it when not in use | • Promote storing or tying up as an easy daily routine done by responsible, caring individuals that takes little to no time |
• Involve children and other household members | |
Washing nets | • Emphasize proper washing practices and frequency – wash net 3–4 times a year in a basin or bucket with water and mild soap, not detergent or bleach |
• Position nets as special, not to be treated like clothes, to be washed infrequently to protect the “medicine” | |
• Keep nets tied up and/or stored when not in use to prevent dirt | |
• Consider procuring coloured nets since they are less likely to show dirt | |
• Manufacturers develop nets with insecticides that can stand a greater number of washes | |
• Conduct trials of improved practices to explore how households can make washing less damaging and frequent | |
Repair behaviour
|
Recommendations
|
Repair (sewing, patching, knotting) | • Promote benefits of repair: malaria prevention purposes; saving money on purchasing a new net and on treatment for malaria |
• Emphasize the ease and short time required to repair small holes | |
• Emphasize checking nets for holes routinely and repairing small holes immediately | |
• Raise perceived dangers of delaying net repair: risk of malaria, financial costs of nets and treatment | |
• Position repair as an intelligent and efficient use of resources | |
• Position those who repair as responsible people who care for their family’s well-being and for having an attractive net and a well-kept home | |
• Promote people who repair as people who are worthy of being appreciated and recognized | |
• Create a norm of repairing by making it public (e.g., net repair as part of school homework) |